anti-HCV Antibodies Research Articles

Impact of Hepatitis C Viral Load in Chronic Kidney Disease Patients‎

Background and study aim: Chronic hepatitis C virus (HCV) infection is linked to chronic kidney disease (CKD) and hastens ‎its progress to end-stage renal disease (ESRD). Previous studies have examined the association ‎between chronic HCV and CKD and reported that HCV is correlated with proteinuria but not with ‎low estimated glomerular filtration rate (eGFR) depending mainly on anti-HCV antibodies to ‎diagnose chronic HCV infection. However, it is the HCV viral load to diagnose active HCV ‎infection. Therefore, our study aimed to elucidate the relationship between HCV viral load and ‎CKD‎. Patients/Material and Method: It’s a cross-sectional observational study that included 204 subjects that were classified into group ‎‎1 (90 chronic HCV patients without a history of chronic kidney disease) and group 2 (114 chronic ‎HCV patients with a history of chronic kidney disease). All subjects underwent full history taking, ‎medical examination, and laboratory investigation from May 2017 to May 2019‎.‎ Results: In CKD patients, HCV viral load was correlated with age, platelet count, serum creatinine, eGFR, ‎and serum bilirubin. Higher HCV viral load was one of the significant predictors of low eGFR in ‎patients with chronic HCV infection in addition to the female sex, older age, lower hemoglobin, ‎higher international normalized ratio, and higher alanine transaminase‎‎‎. Conclusion: There is a strong positive association between HCV viral load and serum creatinine in CKD ‎patients. Higher HCV viral load carries a greater risk for lower eGFR in patients with chronic ‎HCV infection ‎‎.

Screening, confirmation, and treatment rates of hepatitis C virus infection in a tertiary academic medical center in South Korea.

Several barriers prevent the proper screening, diagnosis, and treatment of hepatitis C virus (HCV) infection. We aimed to evaluate the status of HCV screening, confirmation, and treatment rates in a tertiary academic medical center in Korea. Patients who visited Severance Hospital between 2015 and 2019 were eligible in this retrospective study. The testing and positivity rates for anti-HCV antibodies and HCV RNA were sequentially analyzed. Between 2015 and 2019, 252057 patients (117131 men, 46.5%) who underwent anti-HCV antibody testing were retrospectively reviewed. The median age of the study population was 51.0years. Patients with positive anti-HCV antibody test results (n=2623, 1.0%) showed a higher proportion of liver cirrhosis (17.6% vs 2.0%) and unfavorable laboratory test results (all P<0.05). The positivity rates were 1.3% and 0.8% in the medical and surgical departments, respectively. HCV RNA was tested in 1628 (62.1%) patients, with a 57.4% (n=928) positivity rate. The medical department had a higher HCV RNA testing rate than the surgical department (75.4% vs 40.8%). Among the 928 patients who showed positivity for HCV RNA, 847 (90.7%) underwent genotype testing (mostly 1 and 2 [95.4%]). The treatment rate was 66.9% (n=567); it was higher in the gastroenterology department (70.8%) than in the non-gastroenterology departments (62.3%). A considerable proportion of patients testing positive for anti-HCV antibodies were not referred for proper management. Systematic and automated screening and referral systems, which may help identify patients requiring treatment for HCV infection, are necessary even in tertiary academic medical centers.

Survey of hepatitis viruses in blood donor in blood transfusion center in -Al–Diwaniyah

The present study was done to survey the hepatitis infection in the main blood transfusion center in - Diwaniyah during 2019-2020,the ages of donors were 20-63. The sample of blood were drawn from donors 5ml by vein puncture using disposable syringes and the serum was separated by centrifuged. the detection of Hepatitis B virus and HCV by using HbsAg ELISA kit and Anti HCV antibody for detect hepatitis B and C respectively. The the study was included 27312 donor. The percentage of hepatitis viruses was 0.1% from all donor. The percentage of Hepatitis B and C the percentage of hepatitis B infection from total infection is 70% while, its percentage from all donor about 0.076.Hepatitis C infection 9 infection the percentage 30% while its percentage from all donor about 0.032.The percentage of Hepatitis B and C from 30 hepatitis infections was 70% and 30% respectively. The age of donor was was divided into five groups as 20-69 years. The percentage of infection was higher in age 40-49 and the percentage was 40 %,while the distribution of infection in age 20-29 and 50-59 was 20% the percentage of infection in age 30-39 was 16.6% and 3.33 in age 60-69 Also the research was studied blood group by agglutination method and found that A group and O group higher than other groups. The conclusion of this study the HBV more common than other and most patients in A groups.

Impact of antiviral therapy with direct acting antiviral agents (DAAs) on kidney disease in patients with chronic hepatitis C.

Hepatitis C virus and chronic kidney disease are major public health issues all over the world and controversy persists regarding the role of Hepatitis C as a risk factor for the development of chronic kidney disease in the adult general population. Numerous studies found a relationship between positive anti-HCV antibody serologic prevalence and increased frequency of incidence, prevalence and accelerated progression of chronic kidney disease (CKD) over time. However, this has not been universally accepted. One method to analyze the relationship between anti-HCV status and CKD is to evaluate the impact of anti-HCV antiviral therapy on the risk of CKD in the general population. The availability of safe and effective drugs (direct-acting antiviral agents) for HCV eradication supports this approach. Novel data support the notion that sustained viral response with anti-HCV regimens leads to improvement of hepatic and extrahepatic outcomes. A systematic review with meta-analysis of clinical observational studies was recently performed on this point. Fifteen studies were retrieved (N.=356, 285 patients); a relationship between sustained viral response and lower rate of kidney disease was noted- the summary estimate for adjusted risk of kidney disease was 2.5 (95% CI: 1.41; 4.41) (P=0.0016). An association between anti-HCV therapy and reduced risk of kidney disease after comparison of treated vs. untreated cohorts was observed, the summary estimate for adjusted HR was 0.44 (95% CI: 0.25; 0.63) (P=0.0001). Several biologic mechanisms have been cited to explain the detrimental role of HCV on kidney disease in the general population, and a direct and indirect activity of HCV on atherogenesis at kidney level has been mentioned. Clinical and experimental studies are under way.

HCV core antigen plays an important role in the fight against HCV as an alternative to HCV-RNA detection.

ObjectiveTo discuss the clinical significance of HCV‐cAg testing in the diagnosis, activity determination, and monitoring of therapeutic effectiveness of HCV infection and its advantages compared with HCV‐RNA and anti‐HCV antibodies detection.MethodsBy summarizing the published literature, the advantages and significance of HCV core antigen detection were sought.ResultsThe expression of HCV‐cAg is highly consistent with that of HCV‐RNA, but compared with HCV‐RNA, detection of HCV‐cAg is easy to operate, time saving, and low cost. HCV‐cAg can be detected within 12~15 days after infection, and the window period can be shortened by5~7 weeks. HCV‐cAg is a serological indicator of virus replication, which can distinguish previous infection of HCV or current infection. HCV‐cAg detection is more suitable for immunocompromised, hemodialysis, organ transplant patients. HCV‐cAg also can be used to monitor antiviral efficacy and predict sustained virological response (SVR).ConclusionHCV core antigen has similar clinical sensitivity to NAT and can be used as a substitute for HCV‐RNA in the diagnosis of virus infection. Combined detection of HCV‐cAg and antibody serology can help doctors detect HCV infection earlier, accurately diagnose different stages of HCV infection, and evaluate the therapeutic effect of antiviral drugs, which are beneficial in the prevention and treatment of hepatitis C.

Screening of Occult Hepatitis B Virus Infection among Egyptian Blood Donors.

Background:Although sensitive screening assays for hepatitis B virus surface antigen (HBsAg) are available, special cases of post-transfusion hepatitis B virus infection still occur. The present study was conducted to evaluate the prevalence of anti-hepatitis B core (anti-HBc) positivity and the presence of HBV-DNA in serum samples of healthy blood donors negative for both HBsAg and anti-HCV antibodies in Benha, Egypt. Materials and methods: The study included a screening of 450 selected blood donors. The distribution of blood donors was 288 males (64%) and 162 females (36%). The recruited blood donors who met the criteria for blood donation were routinely screened for HBsAg, HIV I/2-Ab, and syphilis-antibodies. The blood units for donations were further analyzed for the presence of HBc-IgM and HBV-DNA levels by PCR method. Results: Testing of the accepted units for the donation was about 12 (2.7%) HBc-IgM positive, and 9 (2%) HBV-DNA positive units. The standard screening of blood unit failed to recognize early acute or window HBV infection where HBsAg is missing. Conclusions:Our investigations proposed that sensitive methods for the detection of HBV by PCR might be recommended in the screening of donated blood. Furthermore, anti-HBc antibodies should be tested regularly on all blood donation units.

Incidence of Hepatitis C Virus Infections Among Users of Human Immunodeficiency Virus Pre-exposure Prophylaxis

Sexual transmission of hepatitis C virus (HCV) is well documented among human immunodeficiency virus (HIV)-uninfected individuals. The use of HIV pre-exposure prophylaxis (PrEP) may be associated with engagement in activities that facilitate the transmission of sexually transmitted infections (STIs) and possibly HCV among PrEP users. Between 2012 and 2019, the incidence of HCV and bacterial STIs were calculated among HIV-negative indviduals receiving PrEP at the University Health Network HIV Prevention Clinic.Mucosal, anal, and blood samples were taken to test for HIV, syphilis, and anti-HCV antibodies. Among 344 HIV-uninfected patients receiving PrEP, 86% were men having sex with men (MSM). Five individuals were HCV-antibody positive at the time of PrEP initiation. Serologic and virologic follow-up data were available for 109 HCV-negative individuals over 282 patient-years (PY). Two new infections were recorded, yielding an incidence of primary HCV infection of 0.7 per 100 PY. In contrast with HCV, the incidence rates of chlamydia, gonorrhea, and syphilis were 49.2 per 100 PY, 36.3 per 100 PY, and 5.2 per 100 PY, respectively. Both individuals with new HCV diagnoses reported being MSM with a history of unprotected intercourse and 1 individual also reported recreational drug use. Both individuals were asymptomatic at the time of diagnosis and the infections were detected by routine laboratory monitoring. The low incidence of HCV infections despite significantly higher rates of other STIs suggests that sexual transmission of HCV is uncommon in HIV-negative MSM PrEP users in this community. Performing routine risk-based HCV surveillance among PrEP users should be evaluated. The high incidence of STIs in this population indicates a vital role for periodic STI monitoring in those receiving PrEP.

The prevalence of HCV RNA positivity in anti-HCV antibodies-negative hemodialysis patients in Thrace Region. Multicentral study.

HCV infection in patients under hemodialysis for end stage chronic kidney disease (ESCKD) may exist despite the absence of anti-HCV antibodies. Molecular methods are widely accepted as "gold standard" techniques for the detection of viral RNA. However, the molecular methods are more expensive in comparison to conventional methods and their replacement is not cost-effective. The aim of this study was to estimate the prevalence of HCV RNA positivity in anti-HCV negative hemodialysis patients and evaluate new diagnostic methods for the detection and the monitoring of hepatitis C in ESCKD patients. The study was performed in four hospitals of Thrace region of Greece and 233 patients with no history of hepatitis C were enrolled. Measurement of anti-HCV antibodies and HCV core antigen was performed by microparticle chemiluminescence immunoassay. Molecular detection of viral RNA was performed by the real-time RT PCR. The mean age of the patients was 64.9 ± 23.3 years. HCV-Ag was positive in 2/233 patients (0.86%). Nevertheless, viral RNA was negative in those patients. The results of the present study showed that the incidence of HCV-RNA in patients with negative anti-HCV Abs, in hemodialysis patients in Thrace region of Greece was negligible (0/233).

Utility of the Cobas® Plasma Separation Card as a Sample Collection Device for Serological and Virological Diagnosis of Hepatitis C Virus Infection.

Diagnosis and clinical management of people infected with hepatitis C virus (HCV) relies on results from a combination of serological and virological tests. The aim of this study was to compare the performance of dried plasma spots (DPS), prepared using the cobas® Plasma Separation Card (PSC), to plasma and serum from venipuncture, for HCV diagnosis. We carried out a prospective study using DPS and paired plasma or serum samples. Serum and DPS samples were analyzed by immunoassay using Elecsys® Anti-HCV II (Roche). Plasma and DPS samples were analyzed using the cobas® HCV viral load and cobas® HCV genotyping tests (Roche). All DPS samples that had high anti-HCV antibody titers in serum were also antibody-positive, as were five of eight samples with moderate titers. Eight samples with low titers in serum were negative with DPS. Among 80 samples with plasma HCV viral loads between 61.5 and 2.2 × 108 IU/mL, 74 were RNA-positive in DPS. The mean viral load difference between plasma and DPS was 2.65 log10 IU/mL. The performance of DPS for detection of serological and virological markers of hepatitis C virus infection was comparable to that of the conventional specimen types. However, the limits of detection were higher for DPS.

A212 INCIDENCE OF HEPATITIS C VIRUS INFECTIONS AMONG USERS OF HUMAN IMMUNODEFICIENCY VIRUS PRE-EXPOSURE PROPHYLAXIS

Abstract Background Sexual transmission of hepatitis C virus (HCV) is well-documented among HIV-uninfected individuals. The use of HIV pre-exposure prophylaxis (PrEP) may lead to increased engagement in activities that facilitate the transmission of sexually transmitted infections (STI) and possibly HCV among PrEP users. Aims To assess the incidence of Hepatitis C Virus Infections among HIV negative pre-exposure prophylaxis (PrEP) users Methods Between 2012 and 2019, the incidence of HCV and bacterial STIs were calculated among HIV-negative patients receiving PrEP at the University Health Network HIV Prevention Clinic. Mucosal, anal and blood samples were taken to test for HIV, syphilis, and anti-HCV antibodies. Results Among 344 HIV-uninfected patients receiving PrEP, 86% were men having sex with men (MSM). Five individuals were HCV-antibody positive at the time of PrEP initiation. Serological and virological follow-up was available for 109 HCV-negative individuals over 282 patient-years (PY). Two new infections were recorded, yielding an incidence of primary HCV infection of 0.7/100 PY. In contrast with HCV, the incidence rates of chlamydia, gonorrhea, and syphilis were 49.2/100 PY, 36.3/100 PY, and 5.2/100 PY, respectively. Both individuals with new HCV diagnoses reported being MSM with a history of unprotected intercourse and one also reported recreational drug use. Both individuals were asymptomatic at the time of diagnosis and were detected by routine laboratory monitoring. Conclusions The low incidence of HCV infections despite significantly higher rates of other STIs suggests that sexual transmission of HCV is uncommon in HIV-negative MSM PrEP users. Performing routine risk-based HCV surveillance among PrEP users should be evaluated. The high incidence of STIs in this population indicates a vital role for periodic STI monitoring in those receiving PrEP. Funding Agencies vircan

Screening of Donated Blood for Transfusion Transmitted Infections by Serology and Response Rate to Notification of Reactive Results: A Tertiary Care Institutional Experience

Background: Safety for blood Transfusion begins with healthy donors. A basic part of preventing transfusion transmitted infections (TTIs) is to notify and counsel reactive donors. This study analysed trends in the prevalence of transfusion-transmissible infectious pathogens among blood donors and notify them as well as to assess response rate among them. Donor notification and counselling protect the health of the donor and stop secondary transmission of infectious diseases.&#x0D; Methods: 38707 blood donations were screened for TTIs, namely, HIV, HBV, HCV, and syphilis, Malarial Parasite by serology. ELISA testing for anti-HIV antibody, anti-HCV antibody and HBsAg and RPR test for syphilis, Rapid card test for Malarial Parasite. All reactive donors were retested in duplicate and notified of their status by communicating through telephone. &#x0D; Result: We evaluated 341 (0.88%) cases with reactive screening test results (0.617% HBV, 0.016% HCV, 0.134% HIV, 0.08% syphilis, 0.031% Malaria ). Only 179 donors (52.5%) responded to notification. The response among voluntary donors was better as compared to the replacement donors (54.1 % versus 40.7 %). Only 101 (57.22%) responsive donors followed their first attendance at referral clinic. &#x0D; Conclusion: Our study provides prevalence rate of TTIs among blood donors and importance of proper donor counselling and notification of TTI status to all reactive donors who opt to receive this information.

A Healthcare-Associated Outbreak of HCV Genotype 2a at a Clinic in Seoul.

ObjectivesAn epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.MethodsA retrospective study of the outpatients and health care workers (n = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1st, 2006 and March 25th, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.ResultsThe rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (p < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (n = 56) or 2 clusters (n = 25). This result indicated exposure to a high-association infection source.ConclusionAnti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.

Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications.

In Malaysia, majority anti-HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost-effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti-viral therapy. A cross-sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti-HCV, HCV Ag, and HCV RNA. Pre-dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. Two-hundred twenty-seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 ± 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p < .001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti-HCV antibody as initial screening, followed by HCV Ag on Anti-HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost-saving algorithm compared to standard diagnostic algorithm. HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle-income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.

Evolutionary seroepidemiology of viral hepatitis and the gap in hepatitis C care cascades among uraemic patients receiving haemodialysis in Taiwan-the Formosa-Like Group.

Uraemic patients undergoing haemodialysis are at high risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We aimed to evaluate the evolutionary seroprevalence of viral hepatitis and the gap in HCV care cascades in this special population by a large-scale surveillance study in Taiwan. Uraemic patients on maintenance haemodialysis from 22 sites (FORMOSA-LIKE group) in 2012 (n=1,680) and 2019 (n=2,326) were recruited for this study. The distributions and sequential changes of viral hepatitis markers were analysed. The prevalence of anti-HCV antibody and hepatitis B surface antigen (HBsAg) seropositivity was 13.6% (316/2326) and 11.5% (267/2326), respectively, in 2019 compared with 17.3% (290/1680, P=.002) and 13.6% (229/1680, P=.046), respectively, in 2012. The HCV-viremic rate among anti-HCV-seropositive patients was significantly lower in 2019 than in 2012 (56.3% [178/316] vs. 73.8% [214/290], P<.001). The HCV treatment rate increased from 2.3% (5/217) in 2012 to 21.7% (49/226) in 2019 (P<.001). In the sequential analysis of the 490 patients who participated in both screens, 17 of the 55 HCV-viremic patients became HCV RNA seronegative, including 13 by antivirals and four spontaneously. By contrast, one anti-HCV-seropositive but nonviremic patient became viremic, and six anti-HCV-seronegative patients became anti-HCV-seropositive in 2019. The annual incidence of new HCV was 0.2%/year. Seven HBsAg-seropositive patients experienced HBsAg loss (1.25%/year). Two patients had new anti-HBc seropositivity (new HBV exposure: 0.57%/year). The seroprevalence of viral hepatitis decreased in an 8-year follow-up but remained prevalent, and the treatment of HCV infection was underutilized in uraemic patients. Additional efforts are needed to enhance the HCV treatment uptake of uraemic patients. Clinical Trial IDs: NCT03803410, NCT01766895.

Subclinical Hepatitis C Virus Infection in Patients with Chronic Obstructive Pulmonary Disease: Evidence from a Cross-Sectional Multicenter Observation Study

Background: Patients with hepatitis virus C (HCV) infection have declined levels of forced expiratory volume (FEV), which is a prognostic marker for chronic obstructive pulmonary disease (COPD). Objectives: The current study primarily aimed to investigate the incidence of subclinical HCV infection (clinical signs are absent but positive HCV RNA test performed by polymerase chain reaction) in patients with COPD of Zhejiang province, China, and its secondary aim was to investigate the clinical influence of HCV infection on COPD severity by body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) scoring index and pulmonary function tests (PFT). Methods: A total of 252 patients with COPD (confirmed by routine lab tests, BODE index, and PFT) were included in a cross-sectional multicenter study. An anti-HCV antibody test was used to diagnose HCV infection. Hepatitis virus C RNA was tested for patients with a HCV antibody-positive test. Results: Twelve patients had a positive anti-HCV antibody test. Of 12 anti-HCV antibody positive test patients, 10 were positive for the HCV RNA. The prevalence of anti-HCV antibody positivity and HCV RNA positivity was 12/ 252 and 10/ 252, respectively. The partial arterial pressure of oxygen was the same for patients with HCV RNA positive test compared to those with a negative anti-HCV antibody test (59.70 ± 5.50 mmHg vs. 63.84 ± 15.63 mmHg, P = 0.791). Patients with a positive HCV RNA test had a higher partial arterial pressure of carbon dioxide compared to those with a negative anti-HCV antibody test (43.70 ± 1.89 mmHg vs. 49.42 ± 7.33 mmHg, P = 0. 007). BODE index was higher for patients with HCV RNA positive test than those with anti-HCV antibody test negative (6 (3 - 7) vs. 4 (2 - 6), P &lt; 0.0001). Among the variables of BODE index scoring, the values of distance walked in 6 min (P &lt; 0.0001) and % predicted forced expiratory volume in 1 s (P &lt; 0.0001) were fewer for patients with HCV RNA positive test than those with a negative anti-HCV antibody test. Conclusion: This study demonstrated that subclinical HCV infection may be observed in COPD patients.

Hepatitis C Rapid Point-of-Care Testing and Laboratory-based Non-invasive Assessment of Liver Fibrosis among Drug Abusers: An Experience from Iran.

People who use drugs, particularly injection drug users (IDUs) are known as the major source of hepatitis C virus (HCV) infection. This study was performed to determine the prevalence of HCV infection using rapid point-of-care testing and to assess liver fibrosis by non-invasive lab tests among addict populations of Mashhad, Iran. In this cross-sectional study, drug users who referred to drug treatment and harm reduction centers of Mashhad were enrolled during March and December 2019. A rapid test kit was used to assess the presence of anti-HCV antibodies and a real-time PCR was performed to confirm the infection. The AST-platelet ratio index (APRI) and fibrosis-4 (FIB-4) score were used to investigate liver fibrosis in patients with positive HCV RNA. A P value <0.05 was considered as significant. A total of 390 drug users aged 15-74 years were assessed. Sixty-four individuals showed positive results for anti-HCV (16.4%), of whom 58 blood samples were available for PCR test. The viremic rate among the latter group was calculated at 84.5% (49/58); the total viremia prevalence was 12.8% (49/384). Multivariate analysis revealed that being single (P = 0.040) or divorced/ widow (P = 0.011) and history of drug injection (P<0.001) and tattoos (P = 0.021) were significantly associated with current HCV infection. Using APRI and FIB-4 indices, significant liver fibrosis was identified in 14.3% and 18.4% of cases, respectively. HCV infection screening using rapid tests and examining liver fibrosis by non-invasive lab tests appear to be practicable and useful among poor populations in settings such as drug treatment centers.

IgE antibodies to hepatitis C virus core and nonstructural antigens in chronic hepatitis C patients before and after antiviral treatment

Few studies on the immunoglobulin E (IgE) immune response in chronic hepatitis C have been reported. In this study, we tested the antigenicity of commercial recombinant hepatitis C virus (HCV) core and nonstructural protein NS3, NS4, and NS5 antigens and the IgE immune response to these antigens in chronic hepatitis C patients before and after antiviral treatment with pegylated interferon (IFN)-α plus ribavirin for 12 weeks. The effects of antiviral treatment were investigated in 20 out of 35 participants. We developed amplified immunoassays using these antigens and IgG-depleted patient sera. Seropositivity for IgE antibodies was determined, and serum IgE and cytokine levels were measured. Anti-core, anti-NS3, and anti-NS4 IgE antibodies were observed in most patients, whereas anti-NS5 antibodies were less prevalent. Antiviral treatment decreased the production of anti-core, anti-NS3, and anti-NS4 IgE antibodies, but not anti-NS5 IgE antibodies. A significant decrease in the anti-NS3 and anti-NS4 IgE antibody levels was observed in patients who presented with an early sustained virological response, but no effects on anti-core and anti-NS5 IgE antibodies was observed. The serum levels of IFN-γ, interleukin (IL)-2, IL-6, tumor necrosis factor-α, and IL-10, but not IL-4, were similar between patients before and after antiviral therapy. Thus, the immune response of IgE antibodies to HCV antigens was comparable to that of anti-HCV IgG antibodies. The usefulness of anti-NS3 IgE antibodies in diagnosing occult hepatitis C and monitoring antiviral treatment with directly acting antiviral medication must be investigated in future studies.

THE HEPATITIS C UNTYPE-ABLE GENOTYPES, AN EMERGENCE OF QUASI-SPECIES IN HCV INFECTED PATIENTS

Objective: To determine the frequency of Type-able and untype-able genotypes in hepatitis C infected patients,and to observe their association with gender, age, Alanine Aminotranferease and viral load.&#x0D; Study Design: Cross-sectional analytical study.&#x0D; Place and Duration of Study: Department of Microbiology, Combined Military Hospital, and Lahore, Pakistanfrom Sep 2017 to Mar 2018.&#x0D; Methodology: Six hundred forty seven anti HCV antibodies positive serum samples by Enzyme Linked ImmunoSorbant Assay were received from a total of 6791 serum samples. The positive sera were subjected to qualitative PCR and quantitative real time (RT) PCR to determine pre-treatment viral load. Quantitative PCR positive sera with viral load &gt;500IU/ml were further subjected to molecular genotyping by using Ohno et al method.&#x0D; Result: Out of 647 positive serum samples, type-specific PCR fragments were seen in 424 sera, while 13 (3.1%) of serum samples were of untype-able genotype. In all age groups genotype 3a had emerged as a predominantgenotype 397 (93.6%), followed by 1b 8 (1.9%), 3b 4 (0.9%), 1a 2 (0.5%), while no sample detected to have 2a, 2b,5a, 6a and mixed genotypes. The highest prevalence of untype-ables were seen in 61-70 age group.&#x0D; Conclusion: Need of the hour is proper sequencing of untype-able genotypes via upgrading existing methodologies. It will not only help the clinicians in achieving sustained virological response but also help in identifying new genotypes/subtypes.

Hepatitis C Virus Infection among HIV-Infected Patients Attending Dessie Referral Hospital, Northeastern Ethiopia.

Objective Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection increases the incidence of end-stage liver disease which is more severe in immune-compromised HIV-infected patients than HCV infection alone. The aim of this study was to assess HCV infection and the associated risk factors among HIV/AIDS patients attending Dessie Referral Hospital, Northeastern Ethiopia. Methods A hospital-based cross-sectional study was conducted among 249 HIV-infected adults selected by a systematic random sampling technique from January to March 2018. A structured questionnaire was used to collect sociodemographic and risk factor data. Moreover, the blood specimen was collected and tested for CD4 count and anti-HCV antibody detection according to standard operating procedures. The data obtained were entered into SPSS version 20, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A P value ≤0.05 with a corresponding 95% confidence interval was considered as statistically significant. Result Of a total of 249 HIV-infected study subjects, 120 (48.2%) were male and 129 (51.8%) were females, while the mean (±SD) age and CD4+ cells/mm3 were 39.10 (±11.507) years and 316.08 + 290.607 cells/mm3, respectively. Anti-HCV antibody was detected in 13 (5.2%) patients with higher prevalence rate found in males (P=0.078) and elders >50 years of age (P=0.013) than their counterparts. Age group of >50 years of age (AOR = 9.070, 95% CI: 1.578, 52.117, P=0.013), longer duration of HIV treatment (AOR = 5.490, 95% CI: 1.341, 34.458, P=0.041), WHO clinical stage III/IV (AOR = 12.768, 95% CI: 2.293, 71.106, P=0.004), previous history of hospitalization (AOR = 10.234, 95% CI: 2.049, 51.118, P=0.005), tooth extraction (AOR = 6.016, 95% CI: 1.137, 36.837, P=0.048), and liver disease (AOR = 11.398, 95% CI: 1.275, 101.930, P=0.029) were statistically significant predictors of HCV infection. Conclusion The prevalence of HCV infection is still higher and causes concern. Therefore, screening of these high-risk groups should be critical to reduce mortality and to improve clinical outcomes.

Polymorphism rs368234815 of interferon lambda 4 gene and spontaneous clearance of hepatitis C virus in haemodialysis patients: a case-control study

BackgroundIn non-uremic subjects, IFNL4 rs368234815 predicts HCV clearance. We investigated whether rs368234815 is associated with spontaneous HCV clearance in haemodialysis patients and whether it is a stronger predictor of HCV resolution than the IFNL polymorphisms already associated with HCV clearance in dialysis subjects. We also evaluated an association of rs368234815 with patients` survival and alterations in transcription factor binding sites (TFBS) caused by IFNL polymorphisms.MethodsAmong 161 haemodialysis patients with positive anti-HCV antibodies, 68 (42.2%) spontaneously resolved HCV infection, whereas 93 remained HCV RNA positive. Patients were tested for near IFNL3 rs12980275, IFNL3 rs4803217, IFNL4 rs12979860, IFNL4 rs368234815, and near IFNL4 rs8099917. IFNL4 rs368234815 polymorphism (TT/TT, ΔG/TT, ΔG/ΔG) was genotyped by restriction fragment length polymorphism analysis; other IFNL polymorphisms - by high resolution melting curve analysis. We used the Kaplan-Meier method with the log-rank test for survival analysis. In silico analysis included the use of ENCODE TFBS ChIP-seq data, HOCOMOCO, JASPAR CORE, and CIS-BP databases, and FIMO software.ResultsThe probability (OR, 95%CI, P) of spontaneous HCV clearance for rs368234815 TT/TT patients was higher than for the ΔG allele carriers (2.63, 1.38–5.04, 0.003). This probability for other major homozygotes varied between 2.80, 1.45–5.43, 0.002 for rs12980275 and 2.44, 1.27–4.69, 0.007 for rs12979860. In the additive model, rs368234815 TT/TT was the strongest predictor of HCV clearance (6.38, 1.69–24.2, 0.003). Survival analysis suggested an association of the ΔG allele with mortality due to neoplasms (log-rank P = 0.005). The rs368234815 ∆G allele caused TFBS removal for PLAGL1.ConclusionsIn haemodialysis patients, the association of rs368234815 with the spontaneous HCV clearance is better than that documented for other IFNL3/IFNL4 polymorphisms only in the additive mode of inheritance. However, identifying the homozygosity in the variant ∆G allele of rs368234815 means a more potent prediction of persistent HCV infection in haemodialysis subjects that we observe in the case of the variant homozygosity of other tested IFNL3/IFNL4 polymorphisms. Removal of PLAGL1 TFBS in subjects harbouring the rs368234815 ∆G allele may contribute to cancer susceptibility. The association of rs368234815 with cancer-related mortality needs further studies in HCV-exposed subjects.